Feb. 8, 2011
The Honorable Robert Duncan
Chairman, Senate Committee on State Affairs
Post Office Box 12068 – Capitol Station
Austin, Texas 78711
Re: Senate Bill 16
Dear Chairman Duncan:
The Texas Medical Association (TMA) is a private, voluntary, nonprofit association of approximately 45,000 member physicians and medical students. TMA was founded in 1853 to serve the people of Texas in matters of medical care, prevention and cure of disease, and improvement of public health. Today, our maxim continues in the same direction: “Physicians Caring for Texans.” TMA’s diverse physician members practice in all fields of medical specialization.
TMA’s member physicians fall on both sides of the abortion debate. TMA’s concerns regarding SB 16, however, do not pertain to that highly political issue. However, TMA is concerned about the dangerous precedent SB 16, and related legislation, would set for health care in Texas—a precedent that would lay the foundation for future lawmakers to establish the details of the interaction between physicians and patients, and allow non-physicians to mandate what tests, procedures, or medicines must be provided to patients and in what timeframe.
The sanctity of the patient-physician relationship is the foundation of health care in America, and it must be preserved to assure candid communication and allow patients to evaluate their care options. The Legislature’s role should not be to dictate how physicians and patients communicate with one another or what procedures and diagnostic tests must be performed on a given patient.
Physician members of the TMA agree to be bound by the American Medical Association (AMA) Principles of Medical Ethics. SB 16, as filed, is contrary to established ethics principles pertaining to the patient-physician relationship and informed consent. For example, the AMA Code of Medical Ethics Opinion 8.08, interpreting the AMA Principles of Medical Ethics, states that in special circumstances, it may be appropriate to postpone disclosure of information. It further states the following:
Physicians should sensitively and respectfully disclose all relevant medical information to patients. The quantity and specificity of this information should be tailored to meet the preferences and needs of individual patients. Physicians need not communicate all information at one time, but should assess the amount of information that patients are capable of receiving at a given time and present the remainder when appropriate.
Furthermore, AMA Code of Medical Ethics Opinion 8.082 states that physicians should honor patient requests not to be informed of certain medical information, and physicians should assess the amount of information a patient is capable of receiving at a given time and should tailor disclosure to meet patients’ needs and expectations in light of their preferences. According to the Code of Medical Ethics, in all circumstances, physicians should communicate with patients sensitively and respectfully.
The TMA Board of Councilors also issues ethics opinions to guide Texas physicians. SB 16 as drafted would force Texas physicians to practice medicine in a manner inconsistent with Texas medical ethics opinions as well as contrary to the AMA Code of Medical Ethics.
TMA is concerned that SB 16 not only sets a dangerous precedent of legislation prescribing the details of the practice of medicine, but it also clearly mandates that physicians practice in a manner inconsistent with medical ethics.
TMA appreciates the opportunity to provide you with our concerns regarding SB 16, and urge you to take these comments into serious consideration. We are willing to provide you with any more information or assistance you may request.
Susan Rudd Bailey, MD,